Biologic agents of warfare

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Biologic agents of warfare

  1. 1. Biologic Agents of Warfare <ul><li>3 categories, prioritized by the CDC </li></ul><ul><li>Category A </li></ul><ul><ul><li>Higher potential for weaponizing </li></ul></ul><ul><ul><li>More history-based risk </li></ul></ul><ul><ul><li>Higher risk of transmission </li></ul></ul><ul><li>Category B </li></ul><ul><li>Category C </li></ul>
  2. 2. BW Category A <ul><li>Small pox* </li></ul><ul><li>Anthrax* </li></ul><ul><li>Plague* </li></ul><ul><li>Botulism </li></ul><ul><li>Tularemia </li></ul><ul><li>Viral hemorrhagic fever </li></ul><ul><li>Variola major </li></ul><ul><li>Bacillus anthracis </li></ul><ul><li>Yersinia pestis </li></ul><ul><li>Clostridium botulinum toxin </li></ul><ul><li>Ebola,marburg, lassa </li></ul>
  3. 3. Small Pox History <ul><li>1754-67 British BW during French-Indian wars in North America. </li></ul><ul><ul><li>Infected blankets intentionally given to American Indians resulting in >50% mortality. </li></ul></ul><ul><li>1977 WHO eradicated small pox </li></ul><ul><li>1978/80s stopped vaccinations in USA & worldwide </li></ul><ul><ul><li>Soviet Union secretly weaponized </li></ul></ul><ul><li>WHO approved repositories of variola in CDC and Institute for Viral Preparations (Moscow) </li></ul>
  4. 4. Small Pox Vaccine Impact on Mortality <ul><li>Never vaccinated </li></ul><ul><li>Post exposure vax </li></ul><ul><li>< 10 years ago </li></ul><ul><li>11-20 years ago </li></ul><ul><li>>20 years ago </li></ul><ul><li>52% case fatality </li></ul><ul><li>29% </li></ul><ul><li>1.4% </li></ul><ul><li>7% </li></ul><ul><li>11% </li></ul>(retrospective US data from 1950-71. Mack 1972)
  5. 5. Similar Conditions Confused with Small Pox <ul><li>Varicella </li></ul><ul><li>Scabies </li></ul><ul><li>Erythema multiforme </li></ul><ul><li>Herpes zoster/simplex </li></ul><ul><li>Impetigo </li></ul><ul><li>Drug reactions (eruptions) </li></ul><ul><li>Contact dermatitis </li></ul><ul><li>Contacts </li></ul><ul><li>Contacts of case </li></ul><ul><li>Contacts of contacts </li></ul>
  6. 6. Anthrax Post-exp prophylaxis <ul><li>1991 Iraq acknowledged weaponizing wet anthrax </li></ul><ul><li>1995 Aum Shinrikyo terrorist group unsuccessfully attempted release in Tokyo subway before using sarin </li></ul><ul><li>Vax + cipro x 30 days </li></ul><ul><li>Ciprofloxacin 60 days </li></ul><ul><li>Doxycycline 60 days </li></ul><ul><li>Amoxicillin 60 days </li></ul><ul><li>If symptoms Hospital IV and po meds </li></ul>
  7. 7. Plague <ul><li>1346 Tartar army hurled infected corpses into Kaffa </li></ul><ul><ul><li>Possible start of Europe’s “Black Death” </li></ul></ul><ul><li>WWII Japanese army dropped plague infected fleas in China </li></ul><ul><li>Post war USA & USSR aerosolized plague </li></ul>
  8. 8. Medieval Infection Control 1500 AD <ul><li>The Plague Doctor </li></ul><ul><li>Beaked Mask </li></ul><ul><ul><li>Filter air stuffed with herbs </li></ul></ul><ul><ul><li>Glass over eyeholes </li></ul></ul><ul><ul><li>Precursor to gas mask </li></ul></ul><ul><li>Stick in hand </li></ul><ul><li>Clock of sealed canvas </li></ul><ul><li>Frighten spirits not microbes </li></ul>
  9. 9. Yersinia pestis (Plague) <ul><li>Environmental Cycle: </li></ul><ul><ul><li>Flea bite  Bubonic Plague  Septicemia  Pneumonic Plague  Contagious Respiratory droplets </li></ul></ul><ul><li>Treatment: </li></ul><ul><ul><li>Infected in natural setting </li></ul></ul><ul><ul><ul><li>Streptomycin or gentamycin </li></ul></ul></ul><ul><ul><li>Mass exposure </li></ul></ul><ul><ul><ul><li>Doxycycline, ciprofloxacin, chloramphenicol </li></ul></ul></ul><ul><ul><li>Vaccine discontinued 1999 </li></ul></ul>
  10. 10. Sarin - Nerve Gas <ul><li>Inhibits cholinesterase </li></ul><ul><li>Organophosphate synthesized in Germany WWII-tested in camps not battlefield </li></ul><ul><li>Iraq alleged to have used them against Iran & the Kurds 1980’s </li></ul><ul><li>1994 & 1995 terrorist attack in Japan </li></ul><ul><li>Clear, colorless, odorless liquid & vapor </li></ul>
  11. 11. Facts about Sarin <ul><li>Inhalation </li></ul><ul><ul><li>Release into air </li></ul></ul><ul><ul><li>Vapor heavier than air </li></ul></ul><ul><ul><li>Clothing can release for 30” more after contact </li></ul></ul><ul><li>Water supply </li></ul><ul><li>Food contamination </li></ul><ul><li>Seconds, minutes to up to 18 hours </li></ul><ul><li>Prevents the chemical that acts as the body’s off switch for muscles & glands---resp.failure </li></ul><ul><li>Supportive care </li></ul><ul><li>Antidote </li></ul>

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